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Adult guardianship, conservatorship and other protective arrangements

Original Link | WashingtonLawHelp.org

Authored By: Northwest Justice Project 
Learn about what adult guardianship is and some alternatives to guardianship. #3300EN

Contents

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Medicare Coverage of Ambulance Services

This official government booklet explains:

  • When Medicare helps cover ambulance services
  • What you pay
  • What Medicare pays
  • What to do if Medicare doesn’t cover your ambulance service
Continue reading “Medicare Coverage of Ambulance Services”

Despite calls to improve, air travel is still a nightmare for many with disabilities

Original Link | NPR

November 9, 202112:57 PM ET
Heard on Morning Edition
By Joseph Shapiro, Allison Mollenkamp

A man using a wheelchair hands his ID to an officer at a security screening checkpoint at Orlando International Airport in 2020.
Paul Henness/SOPA Images/LightRocket via Getty Images

Anxiety, dread, humiliation — even potential injury. For many people with disabilities, these are part of the routine of airline travel, from getting to the airport gate to getting on and off the plane.

In 2018, Congress demanded that airlines and the Transportation Security Administration (TSA) make flying better for people with disabilities — but three years later, NPR has found, passengers report that the same problems keep happening over and over.

On a trip last year, Heather Leiterman, who is blind, was told by a TSA agent to take the harness, collar and leash off her guide dog, a black Labrador named Coastie. She explained to the agent that to do so would mean she’d lose control of the animal.

“That’s how they know they’re working. When the harness is on, they’re working. When the harness is off, that’s when they’re just a dog.”

But the agent insisted — even though the TSA’s own procedures say those items “do not require removal” for screening. “He was very hostile,” Leiterman says, and threatened not to let her on the plane if she didn’t comply.

Continue reading “Despite calls to improve, air travel is still a nightmare for many with disabilities”

Air Ambulance Use and Surprise Billing

*This document examines Air Ambulance surprise costs and slightly touches on the reasons for the for-profit price hikes, however does not address international air ambulance flights, which appears to not be regulated by any means.

ASPE | Office of Health Policy

Available evidence suggests that air ambulance transport isincreasing. Recent
federal legislation and regulation address surprise billing and data gaps.

Gina Turrini, Joel Ruhter, Andre R. Chappel, and Nancy De Lew

KEY POINTS

  • Air ambulances are typically used to transport patients from the scene of an injury or anaccident
    to hospitals, or between hospitals, particularly in criticalsituations when the time to treatment is
    urgent or when patients cannot safely travel by ground ambulance transportation.
  • While the number of air ambulance transportsis low – roughly 1 per 4,000 privately insured
    people per year and 1 in 350 Medicare beneficiaries – available evidence suggests there has been
    an increase in bases (where aircraft are stationed, typically airports or helipads) and
    providers/suppliers* (particularly independently owned and operated companies) in recent years and a shift towards for-profit entities.
  • Patients typically do not have a choice in air ambulance providers, and providers often do not
    inquire about insurance, leading to the potential for large out-of-pocket costs for privately insured
    or uninsured patients. Air ambulance providers are not allowed to send balance bills (when an
    out-of-network provider bills an individual for the difference between the billed charge and the
    amount paid by their plan or insurance) to Medicaid or Medicare patients but privately insured
    individuals do not have the same protections against balance bills for air ambulance transports.
  • A Government AccountabilityOffice Report found that in 2017 the median price charged for a
    rotary wing (e.g., helicopter) ambulance transport was $36,400 versus $40,600 for a fixed-wing
    (e.g., airplane) ambulance transport. The Airline Deregulation Act of 1978 prevents states from
    regulating prices charged by air carriers(which includes air ambulance transport).
  • The No Surprises Act, a component of the Consolidated Appropriations Act, 2021, addresses
    surprise air ambulance bills, effective January 1, 2022. Privately insured patients will pay only the
    deductibles and copayment amounts that they would have paid for in-network air ambulance
    providers, and balance billing will not be allowed.
  • Information has been limited on air ambulances and their charges. The No Surprises Act
    addresses this issue by requiring reporting by air ambulance companies and health plans on cost,
    quality and other data to the Departments of Transportation and Health and Human Services.
Continue reading “Air Ambulance Use and Surprise Billing”

In Washington, who makes your medical decisions if you can’t?

Original Link | On Behalf of Parr Price Law, PS | Aug 31, 2021 | estate planning

When preparing for end-of-life and long-term health care decisions, there are two main tools available: Medical powers of attorney and living wills. 

What if you have neither of those at a critical medical moment when you’re suddenly unable to speak for yourself? If neither a power of attorney nor a living will is in place, Washington State has a legal hierarchy that dictates who can make healthcare decisions on your behalf.

9 levels of priority in Washington

According to the Washington State Hospital Association, there are nine tiers of possible decision-makers when a medical power of attorney is not appointed. This is also in the absence of an advance directive that the patient made, which outlines their wishes regarding health care and end-of-life decisions. The hierarchy is as follows:

  • Legal guardian, if the patient is a minor
  • Spouse or domestic partner of the patient
  • Children of the patient who are at least 18 years old
  • Parents of the patient
  • Siblings of the patient who are at least 18 years old
  • Grandchildren of the patient who are at least 18 years old
  • Nephews and nieces of the patient who are at least 18 years old
  • Uncles and aunts of the patient who are at least 18 years old
  • A close friend of the patient who is at least 18 years old (although special stipulations apply to this last category)

Proactively undergoing comprehensive estate planning can help to avoid the decision-making power falling onto someone who may not be prepared to handle the job. When planning for long-term medical and end-of-life decisions, it can be helpful to have professional guidance that is experienced in estate planning in Washington State. 

Access to Airports by Individuals with Disabilities

Original Link | Government Accountability Office

United States Government Accountability Office

PASSENGERS WITH DISABILITIES
Airport Accessibility Barriers and Practices and DOT’s Oversight of Airlines’ Disability-Related Training

What GAO Found

Passengers with disabilities face infrastructure, information, and customer service barriers at U.S. airports, according to representatives of selected airports, disability advocacy organizations, as well as a review of relevant literature.

  • Infrastructure barriers can include complex terminal layouts and long distances between gates and can be difficult for some to navigate.
  • Essential travel information is not always available in a format accessible to all. For example, a person with hearing loss could miss crucial gate information that is solely provided over a loudspeaker.
  • A passenger might not receive appropriately sensitive service, such as wheelchair assistance, at the airport, although the service provided is required by the Air Carrier Access Act of 1986 (ACAA) regulations.
  • According to stakeholders, while no solution meets all needs, a number of
    practices can help reduce or eliminate some of these barriers to equal access at
    airports. For example, some selected airports use external disability community
    and passenger groups to proactively engage in identifying barriers and develop
    solutions. Other airports have implemented technology-based solutions, such as
    mobile phone applications to make airport navigation easier.
Continue reading “Access to Airports by Individuals with Disabilities”

Filing for Guardianship in WA: Steps to Protect Your Family

Original Link | Trucelaw.com | Posted on March 19, 2019.

This past week I prepared pro se divorce forms for the mother of an adult with special needs. After completing the divorce she plans to file for guardianship of her 22-year-old son. She doesn’t have a lot of extra money for legal services, so she asked if she can file for guardianship in Washington State without an attorney?

Yes, it is possible to become a guardian without an attorney. Keep in mind the process is complicated, so advice from an expert can only help you. Although, if you can’t afford legal fees or you’re just a do it yourselfer with the time to learn, you can file for guardianship on your own. This post is designed to make the process as easy to understand as possible.

Table of Contents

A. First Steps
  1. Who can use this guide?
  2. Deciding if guardianship is the best option
  3. Are there risks with self-representation?
  4. How to use this guide?
  5. How long will it take to complete?
  6. Who is eligible to act as a guardian?
  7. How much does it cost?
B. The Paperwork – Preparing the Documents & Filing
  1. Which documents are required?
  2. What are general rules for filling out the forms?
  3. Do I file everything at once?
  4. Where do I go to start the case?
  5. How do I file?
C. The Court Date
  1. What do I do if the court schedules a hearing?
  2. What to expect at the hearing?
  3. Final steps to finalize the process
Continue reading “Filing for Guardianship in WA: Steps to Protect Your Family”

Stop outrageous air ambulance bills by disclosing the transport price

*An opinion piece examining surprise costs of balance billing and the problems with surprise costs in the US, written prior to the No-Surprises Act in 2022, We haven’t found much useful information on the efficacy of the No-Surprises act as it is so new and the industry has been so opaque for so long. It is important to note that this does not seem to impact international air ambulance flights to the US, solely those within the US. Medicare does seem willing to cover the US portions of Diana’s Air Ambulance with a deductible.

Original Link | STAT | By Kevin Schulman, Barak Richman and Arnold Milstein

Although so-called surprise medical bills have become commonplace and routinely provoke outrage, even those numb to the staggering charges by hospitals are horrified by the avarice of many air ambulance companies.

Generating bills that can exceed $500,000, air ambulances are the giant squid of surprise bills that suffocate unsuspecting patients. One air ambulance bill sought $54,727 from a Bismarck, N.D., woman for a transport that would have taken less than one hour by ground, even after a ground ambulance had already arrived at the scene and had stabilized her. Her insurance paid for less than $14,000, leaving her with a $41,029 bill.

These staggering charges are caused by a confluence of market failures. First, as with all surprise bills, the price is hidden. When patients can’t shop for less-expensive alternatives, they are stuck with inflated prices. But hiding prices — and then allowing providers to charge outrageous amounts after service is provided — also fuels excessive supply, since many providers are eager to capitalize on the inflated profits.

Economists have long focused on the concept of moral hazard, in which demand increases because insurance pays for a large portion of the bill. The story of air ambulance bills illustrates the impact of moral hazard on suppliers, where both price and quantity of services are artificially inflated.

Continue reading “Stop outrageous air ambulance bills by disclosing the transport price”

WASHINGTON HEALTH LAW MANUAL

Original Link | WSSHA.org

*Washington Health Law Manual – WSSHA – SEE CHAPTER 2 (very dense with legalese, it will be likely more helpful if you’re looking for answers to a specific question)

Washington Health Law Manual
Fourth Edition

Forward

On behalf of the Washington State Society of Healthcare Attorneys (“WSSHA”), we would like to thank the many volunteers who have made and continue to make this Washington Health Law Manual (the “Manual”) possible. Their donations of time and contributions of material are a true testament to the scope and breadth of professional health law resources available in the state of Washington. We are honored and grateful to work with a generous group of colleagues. The Washington Health Law Manual is now in its Fourth Edition and maintained in an online format. The manual was previously published in 1996, 1998, and 2006, and we acknowledge the countless hours of all the volunteers who made the Fourth Edition and prior versions possible.

Our current use policy permits free printing and use by health care managers, practitioners, and attorneys who primarily practice within Washington State. We anticipate re-visiting this use policy when we have a better understanding of resources necessary to maintain the Manual.

Aside from the use policy, no part of the Manual may be reproduced or transmitted in any form or by any means, electronic or mechanical, for any purpose without the express written permission of the Washington State Society of Healthcare Attorneys.

Authors maintain the right to use their contributions in other settings (e.g., distribution to their clients or postings on their own website). We have not provided (and do not intend to provide) links to websites maintained by the contributors. We expect all authors to recognize contributions of co-authors, editors, and former authors and editors where the current author updated and used materials from a prior version.

Each chapter provides an approximate date when the author completed his or her preparation of the chapter (the “Reference Date”). And while the reader should be mindful that the chapters do not provide an exhaustive analysis of any topic as of any particular date, the reader should certainly consider significant laws, regulations, decisions, and other resources that became available after the Reference Date.

DISCLAIMER

This publication is designed to provide accurate and authoritative information with respect to select subject matters. It is provided with the understanding that no publisher, author, editor, or contributor hereto, is engaged in rendering legal or other professional services. The information contained herein represents the respective views of individuals participating in the project, which may not necessarily be the views of any government agency or employer of an individual participant. No publisher, author, editor, contributor, or other person participating in this project warrants that any information contained herein is complete or accurate. If legal advice or other expert assistance is required, the services of a competent licensed professional should be sought.

Table of Contents

Chapter 1 – Consent to Healthcare: Special Consent Rules
Chapter 2 – Consent to Healthcare: Decision Making for Incompetent Patients
Chapter 3 – Healthcare Rules Applicable to Certain Populations
Chapter 4 – Commitment Based on Mental Illness
Chapter 5 – Certificate of Need
Chapter 6 – Peer Review and Quality Assurance Requirements
Chapter 7 – Tax Exempt Bond Financing and Long Term Financing
Chapter 8 – Washington State Fraud and Abuse Prohibitions
Chapter 9 – Mental Health Advance Directives
Chapter 10 – Government Investigations of Health Care Providers

COPYRIGHT

Copyright ©2019-present, Washington State Society of Healthcare Attorneys. All rights reserved.

WSSHA thanks the following firms and organizations for sponsoring a chapter(s) of the 4th Edition of the Health Law Manual.

UNDERSTANDING AIR AMBULANCE INSURANCE

Original Link | NAIC | National Association of Insurance Commissioners

Minutes matter after an accident, heart attack, stroke or other major medical emergency. Air ambulances, also known as medevac services, quickly transport a patient to a medical facility. While some health insurance policies provide coverage for this service, coverage gaps can leave patients struggling to pay large bills. Here are the basics of what you should know about air ambulances from the National Association of Insurance Commissioners (NAIC).

Continue reading “UNDERSTANDING AIR AMBULANCE INSURANCE”